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Initial evidence for reliable and valid use of scores on the 8-item Econ-QOL short form to measure economic quality of life in caregivers of persons with traumatic brain injury

Published:August 06, 2022DOI:https://doi.org/10.1016/j.apmr.2022.07.015
Initial evidence for reliable and valid use of scores on the 8-item Econ-QOL short form to measure economic quality of life in caregivers of persons with traumatic brain injury
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      Abstract

      Objective

      To provide reliability and validity data to support the clinical utility of Econ-QOL scores in caregivers of civilians and service members/veterans (SMVs) with TBI.

      Design

      Cross-sectional survey study.

      Setting

      Three academic medical centers and a VA treatment facility.

      Participants

      376 caregivers of civilians (n=213) and SMVs (n=163) with TBI.

      Interventions

      N/A.

      Main Outcome Measures

      Econ-QOL and several patient-reported outcome measures (TBI-CareQOL Caregiver-Specific Anxiety and Caregiver Strain, PROMIS Sleep-related Impairment, Neuro-QoL Positive Affect and Well-being) and measures of financial status (self-reported income).

      Results

      Internal consistency reliability of the Econ-QOL short form scores were excellent (all Cronbach's alphas ≥0.92). There were no floor or ceiling effects for scores. There was evidence of convergent and discriminant validity, with the Econ-QOL scores having the strongest relationships with self-reported income (convergent validity evidence), and weak relationships with the other measures (discriminant validity evidence). Individuals with scores that were “below or possibly below” the poverty line (according to 2016 Federal Government poverty level thresholds) reported worse economic QOL relative to those individuals that were definitely above the poverty line, supporting known-groups validity.

      Conclusions

      This report establishes the clinical utility of scores on the Econ-QOL Short Form in caregivers of persons with TBI and provides evidence that it is valid and appropriate to use such scores not only in a variety of different disability populations (e.g., spinal cord injury, stroke) but also in caregivers.

      Key Words

      List of abbreviations:

      CAT (Computer Adaptive Test), ECON-QOL (The Economic Quality of Life Measure), HRQOL (Health-Related Quality of Life), PROMIS (Patient-Reported Outcomes Measurement Information System), Neuro-QoL (Neurological Quality of Life Measurement System), SMV (Service Member/Veteran), TBI (Traumatic Brain Injury), TBI-CareQOL (Traumatic Brain Injury Caregiver Quality of Life), VA (Veterans Affairs)
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      Article Info

      Publication History

      Accepted: July 28, 2022
      Received in revised form: July 21, 2022
      Received: February 28, 2022

      Publication stage

      In Press Journal Pre-Proof

      Footnotes

      Acknowledgements: Work on this manuscript was supported by grant number R01NR013658 from the National Institutes of Health (NIH), National Institute of Nursing Research, as well as contract funding from the General Dynamics Information Technology, Inc., subcontractor for the Defense and Veterans Brain Injury Center (DVBIC; DVBIC-SC-14-003; W91YTZ-13-C-0015). Funding from the National Center for Advancing Translational Sciences (UL1TR000433) provided support for data collection. We thank the investigators and research associates/coordinators who worked on the study, the study participants, and organizations who supported recruitment efforts. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

      TBI-CareQOL Site Investigators and Coordinators: Noelle Carlozzi, Anna Kratz, Amy Austin, Jenna Russell, Jenna Freedman, Jennifer Miner (University of Michigan, Ann, Arbor, MI); Angelle Sander (Baylor College of Medicine and TIRR Memorial Hermann, Houston, TX), Curtisa Light (TIRR Memorial Hermann, Houston, TX); Robin Hanks, Daniela Ristova-Trendov (Wayne State University/Rehabilitation Institute of Michigan, Detroit, MI); Tracey Brickell, Rael Lange, Louis French, Sara Lippa, Rachel Gartner, Megan Wright, Angela Driscoll, Diana Nora, Jamie Sullivan, Nicole Varbedian, Lauren Johnson, Heidi Mahatan, Paula Bellini, Jayne Holzinger, Jennifer Freud, Ashley Schaper, Maryetta Reese, Elizabeth Barnhart, Vanessa Ndege, Yasmine Eshera, Jenna Weintraub, Mary Andrews, Kaitlyn Casey, Gabrielle Robinson (Walter Reed National Military Medical Center/Defense and Veterans Brain Injury Center, Bethesda, MD); Jill Massengale, Risa Richardson, Leah Drasher-Phillips, Kristina Martinez, Padmaja Ramaiah (James A. Haley Veterans Hospital, Tampa, FL).

      Identification

      DOI: https://doi.org/10.1016/j.apmr.2022.07.015

      Copyright

      © 2022 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine

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